FODMAP Diet: Everything You Need to Know about the Bloat-beating Food Plan

Hailed by some as the answer to serious bloating issues, the key to nixing your IBS and endorsed by Kirsten Dunst and Tyra Banks, it feels like the low-FODMAP diet could become the new 'gluten-free'.

But let's hold on a second. Because this is one way of eating that, when done to its full extent, should be done under medical supervision. Why? 'This diet can starve your good bacteria – and hangry bacteria are not nice,' says Dr Megan Rossi, AKA The Gut Health Doctor.

So, First Things First — What Are FODMAPs?

The acronym, coined by Peter Gibson, a professor of gastroenterology at Monash University in Melbourne, Australia, stands for ‘fermentable oligosaccharides, disaccharides, monosaccharides and polyols’, which are short-chain carbohydrates present in everything from classic gut offenders like bread to healthy favourites such as avocado, cashews and even coconut water. Yes. Sad times.

Though it's a lot of complicated science, the offending things are fermentable sugars which are present in natural and processed foods.

Polyols: e.g. sorbitol and mannitol (found in some fruits and vegetables)

What's so Bad About FODMAPs?

These prebiotic compounds are poorly absorbed in the small intestine and so pass undigested into the colon, where they are rapidly fermented by colonic bacteria.

This is a natural process but, if you're prone to those irritable bowel syndrome (IBS)-type symptoms, the gas produced by burning through the FODMAPs in your diet can cause a world of stomach trouble because, scientists believe, you've got a bowel that's physiologically more sensitive to being stretched.

'Colonic bacteria in people with IBS may react differently to certain types of food, increasing the amount of gas produced and water content in the colon,' says Dr Majella O’Keeffe, dietitian and post-doctoral research associate at King’s College London, who is investigating the effects of FODMAPS.

But it isn’t the FODMAPs themselves that trigger a reaction, it’s the impact they have on the gut.

'FODMAPs are either absorbed slowly from the small intestine or not absorbed at all. We all get symptoms from them – if you eat a can of baked beans, you’ll probably get a bit of wind,' explains Dr Gibson.

'When the FODMAPs move into the bowel, where they are fermented by bacteria, this produces gas and can also cause water to move into the bowel. This stretches the bowel wall, which stimulates the gut.' (That’s science-speak for the urge for a post-meal toilet dash.)

What Is a FODMAP Diet?

Let's dog into the low-FODMAP diet, explained.

It basically means cutting your intake of these foods as Dr Gibson 'found that when you remove FODMAPs from the diet altogether, the impact on [IBS] symptoms was greater than if you just removed fructose or lactose by themselves.'

Then you should reintroduce foods one FODMAP at a time to help discern the ones you can tolerate from the ones you can’t.

'At the moment, there is no clinically diagnostic test for FODMAP sensitivity,' explains O'Keeffe. Instead, it involves an elimination diet and then gradual reintroduction of various high-FODMAP foods to identify individual triggers and work out tolerance thresholds.

Today, dieticians are overt in recommending an elimination phase of four to six weeks, before a reintroduction phase.

So What Can You Eat on a Low-FODMAP Diet?

The lists of foods you can (and can't) eat on a FODMAP diet are lengthy and complex, so it's best to check out the FODMAP diet app, created by the Monash University. Or you can go tech-free with cookery book The Low Fodmap Diet Cookbook, (written by dietitian Dr Sue Shepherd, who was part of Gibson's team that developed the low-FODMAP approach), which was published early this year and contains FODMAP diet recipes.

Unlike some diets, there aren't the usual categories. People often want to know: are eggs low-FODMAP? Eggs and cheeses (apart from cream, halloumi and ricotta) are, but animal milks aren't. You get the gist.

As mentioned, you don't want to go fully low-FODMAP without medical advice, so do head your GP, first.

What Can't You Eat on a Low-FODMAP Diet?

Onions are garlic are a real no-go, but apart from that it's a giant list that it's best to check out on the app or in Shepherd's book.

The list of what to restrict runs across all of the food groups, from fruit and vegetables to health alternatives like agave syrup to hidden ingredients like the soy flour used in many crisps, sausages and protein bars.

Low-FODMAP Diet Benefits

Leading the research at Monash, Gibson found a diet low in FODMAPs helped relieve IBS symptoms in 70% of sufferers.

Though proving that a specific way of eating improves health is hard, the latest review of observational studies and clinical trials concluded the evidence for the low-FODMAP diet is now so strong, it’s ready to be rolled out as first-line therapy for IBS patients and is already in practice in Australia.

Are There any Dangers of a Low-FODMAP Diet?

Yep, scroll on to dig into them.

1/ Disordered eating

A small section of research points to a rather troubling trend: beyond the physical impact of this diet, the mental toll is going unnoticed.

A recent article published in theJournal Of Gastroenterology & Hepatology explored the latest developments in the low-FODMAP diet. And, amid the head-spinning science, there are two words you’re bound to know: disordered eating.

In theory, reintroduction should be simple. But, in reality, the sheer number of FODMAP-containing foods makes this diet trickier than most.

The list of things you can’t eat reads like an everyday shopping list. There’s the home-cooking staples like onions and garlic; the snacks you probably munch on without thinking, like apples and cashews; the but-I-thought-they-were-healthykombucha and camomile tea; and that’s before you throw in the likes of muffins, wine and cream cheese.

While there is, of course, a list of foods you can eat, the result can be launching yourself into a restrictive diet with a good food/bad food mentality. A list of high- and low-FODMAP foods is one thing, but it can’t tell you the ins and outs of this diet for your own body.

'The data collected on the amount of FODMAPs in certain foods is protected,' explains Dr Megan Rossi (@theguthealthdoctor'), a research associate at King’s College London who also runs a gut clinic on Harley Street.

'Decide to measure your macros and that data is readily available online – how many grams of protein there are in a handful of nuts, for example – but there are only a few places in the world that measure FODMAP data and they don’t publish it widely. It is protected in this way for a reason – because it’s such a restrictive diet. If you’re working on wrong information, you could be cutting out the wrong things or restricting too much.'

2/ Gut health

An increasing breadth of research shows that gut diversity is linked to everything from immunity and metabolism to clear skin and mental health.

'Prebiotics are mostly FODMAPs so, the theoretical risk is that by eliminating them or cutting down on them significantly, you’re going to create an environment in your bowel where you won’t have as many health-promoting microbiota,' Gibson warns.

If you feel the FODMAP approach isn’t for you, there are increasingly other options. Researchers are actively working towards building an evidence base for other approaches to IBS treatment, from hypnotherapy to yoga.

Do You Lose Weight on the Low-FODMAP Diet?

However, tackling these issues — like bloating and cramping — can make it easier to know if you’re hungry or satiated, cutting down on snacking and grazing which in turn can lead to eating less. In short, trying the FODMAP diet plan to lose weight isn’t sensible as a number one priority — especially when bearing in mind the connection with disordered eating.

What Is Low-FODMAP Diet for IBS?

It’s the same as the low-FODMAP diet, which is also known as the IBS diet.

If you or someone else is thinking of going FODMAP-free, first see your GP, who can rule out a condition like coeliac disease and point you in the direction of a dietitian to supervise the tricky elimination stage.

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